Ep 160: Haven Miscarriage Clinic - interview with founder Hannah Meurer, CNM

In this episode of the Aligned Birth Podcast, Dr. Shannon interviews Hannah Meurer, a certified nurse midwife and founder of Haven Miscarriage Clinic. They discuss the need for a specialized clinic for early pregnancy loss and the lack of support and resources available to women who experience miscarriages. Hannah shares her personal experience of having complicated pregnancies and a miscarriage and the emotional toll it took on her. She emphasizes the importance of providing support and guidance to women going through miscarriages and aims to humanize the experience through Haven Miscarriage Clinic. 

Haven Miscarriage Clinic offers comprehensive services for early pregnancy loss, providing clinical management, counseling options, and mental health support. The clinic focuses on the management of miscarriages up to 13 weeks, offering services such as ultrasound and medication management. They also provide follow-up blood work, genetic testing for the baby, and mental health consultations. Haven Miscarriage Clinic aims to reduce the stigma surrounding miscarriage and provide a safe and supportive space for women who have experienced pregnancy loss. They are a nonprofit organization and accept donations to support their mission.

Resources:
Haven Miscarriage Clinic
Instagram
Facebook
Ways to donate:
https://www.zeffy.com/en-US/donation-form/f771bf54-b9c0-42af-834f-f8a7b4c9781b

https://www.paypal.com/donate/?hosted_button_id=WMMFYG8F89ZAS

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Transcript

Dr. Shannon (00:04.941)
Hello, hello, you are listening to the Aligned Birth Podcast. I am one of the hosts of the show. I'm Dr. Shannon, prenatal chiropractor. And Rachel, my co -host is not with us today, but that means that we have a special guest on. So we've got an interview with a local birth worker, a local Metro Atlanta birth worker. And so we have Hannah Muir, and she's a certified nurse midwife. And we are going to talk about Haven Miscarriage Clinic, which she is...

founder, owner of, and has recently created. So I've put this in the title of the show as far as any sort of warnings for you if you've experienced a miscarriage or if that is a very sensitive topic, which it is, but the goal of this show is to really provide some support and resources and so, and bring some enlightenment to that. So again, today we have Hannah Muir on. She's a certified nurse midwife and pregnancy loss mom who has been on a personal mission.

to uncover why women in the US continue to have overcomplicated and traumatic early pregnancy loss experiences. She is fighting to humanize the miscarriage experience and has founded the only nonprofit miscarriage specialty clinic in the US. She graduated from Vanderbilt University 2015 and has experience working at a federally qualified health center and private practice, teaching virtual childbirth classes and providing concierge OB care.

She's delivered hundreds of living babies and feels just as honored to be trusted to walk with women throughout their pregnancy loss journeys. So I'm excited to have you on the show today, Hannah.

Hannah Meurer (01:40.016)
So excited to be here. Thank you for having me. And a warm welcome.

Dr. Shannon (01:41.837)
Yay! Of course. Yes! Now, so this is one of those shows where I've kind of been, low -key stalking this guest, so I don't, I haven't met her in real life, and so one day I will meet you in real life. It's gonna be amazing. but I'm so excited to have you on, so it's one of those, like, yeah, I've just, yes! First little hug.

Hannah Meurer (02:02.64)
I'm giving you a virtual hug, right?

Dr. Shannon (02:07.117)
But it had come, and this was like the fastest turnaround. We were talking about this before recording, fastest turnaround for recording. Because I had Megan Hall, who's a doula, I had her on at one point and it took a year. I reached out and then it was like, she's like, I don't know if I'm ready and all these things. And so, and then with you, I like pretty much reached out last week and you were like, yes, name a time, let's do it. Like it's like, we gotta do it now. So I love this turnaround time. Because we're in the midst of summer now, which is, you know, pure chaos with moms and families.

Hannah Meurer (02:11.024)
Mm -hmm.

Hannah Meurer (02:17.584)
Love you again.

Hannah Meurer (02:35.088)
Absolutely, absolutely. We just piece it together.

Dr. Shannon (02:37.389)
We just figured out, we roll with it. But I had come across, you had created a social media page for Haven Miss Carriage Clinic. And when I saw it, I was like, okay, this is again your sign, Shannon. You've got to have her on the show. And so I want to go over, there's lots of things I want to touch on because as with most birth workers, the reason why we do what we do is intertwined with...

our story, our birth a lot of time, everything that has led up to that. So I know we're going to kind of dive through it all with you and everything that we have going on. So let's first start off with what is Haven Miscarriage Clinic? Because I kind of want to start with, let's define that and then go through the nuances of like, well, this is why it came about as well and the need for it.

Hannah Meurer (03:04.176)
Mm -hmm. Yeah.

Hannah Meurer (03:12.08)
I'm here for it.

Hannah Meurer (03:27.92)
Yeah, yeah, I think that's a good order. So, haven miscarriage, as you mentioned in the bio, is the first outpatient specialty clinic. So, as most people know, miscarriage is really common, right? About 20 % of reported pregnancies, that being said, a lot of them go unreported. So, we're thinking probably closer to one in four pregnancies end in loss.

Dr. Shannon (03:41.165)
Mm -hmm.

Dr. Shannon (03:52.461)
probably say that 80 % of the moms in my office have had one or multiple or some some level of that so yeah yeah it's very very common.

Hannah Meurer (03:56.72)
At least one. Sure, sure. And some moms have had three living children and six losses, and then others have had three living children and no losses. So it kind of all shakes out to about one in four is what we would say. With how common it is though, interestingly enough, there's not any specialty in early pregnancy loss care. There's not a specific place.

Dr. Shannon (04:03.661)
Mm -hmm.

Dr. Shannon (04:11.661)
Mm -hmm.

Hannah Meurer (04:23.952)
for women to go and so our options are really limited with location of management. So you really have two options. You can go to the emergency room if you're having any symptoms or if it's on the weekend or you can go to your OB -GYN which notoriously is hard to get into same day. So we have two options. The ER is also a very insensitive setting. You wait for eight hours.

You get a large bill and a lot of times you don't have an empathetic female provider who's been through it can give you any counsel and they do testing, they confirm there's not a heartbeat, then they send you home. So a lot of times no management is even done and then it's left to the grieving person to coordinate care with OB, get in. So then your best alternative is you go into an OB clinic that has baby pictures all over the wall.

Dr. Shannon (05:05.037)
Mm -hmm.

Dr. Shannon (05:14.029)
to go back to the OB and figure that out, yeah.

Hannah Meurer (05:22.32)
that has pregnant moms waiting in the waiting room and postpartum strollers with their babies. And even still, the follow -up is lacking with labs, with ultrasound, with counseling and guidance. So as you said, of course, I experienced a loss that was super complicated. I was a miscarriage or I was a midwife when I miscarried. And so I thought I was handling it really matter of fact.

like even numbers that I'm throwing out, we don't have a ton of research. So we think 50%, maybe 70 % of miscarriages are caused by chromosomal abnormalities. So I was like, that's probably what happened here. And I chose to do medication management. I was like, I just want it over with, which a lot of people can relate to. Like babies passed away. I want this process to be done. So.

The most excruciating experience to take the side attack. It happened at home. Not to be too graphic, but I'm always bluntly honest. It felt like my rectum was ripping apart. I asked God to just kill me. I was like, I'm done. I don't want to do any of this anymore. So I thought that was over when the whole process, what I thought stopped. I went back to work, delivering babies, which...

was very triggering, even though I pushed all of this down. People had the same due date as me. All of these triggers lined up and I thought I was okay, like a lot of people do, right? Like I was semi -early, I was nine weeks. So just went back and kept myself busy. Then I noticed that I had a fever, like two weeks later. And my partner was like, go to the ER, see what's going on. So I went to the ER.

Dr. Shannon (06:47.853)
Mm -hmm.

Hannah Meurer (07:14.512)
exquisitely tender uterus. Once again, I was alone by myself getting an ultrasound in the ER, crying, had endometritis, which is a uterine infection. So they had to keep me inpatient, do a DNC. I stayed on IV antibiotics and then ended up going home. Thought everything was fine. Obviously it wasn't. So a few weeks later, my HCGs were still up. And so they did another ultrasound.

Dr. Shannon (07:37.869)
Mm -hmm.

Hmm.

Hannah Meurer (07:43.28)
They saw vascularity in my uterus and they thought I had what's called an AV malformation, which can sometimes happen as a result of a DNC. And I was like, typical, like, you know, if you're a Brit, you're like midwife curse, nurse curse, or whatever it is. I was like, this just cannot be easy. So got a CT scan with angiogram, looked at the vascularity. They definitely thought that's what it was. So then I had an interventional radiologist. They went through,

Dr. Shannon (07:48.077)
Yeah.

Dr. Shannon (07:58.089)
huh, yep.

Hannah Meurer (08:13.52)
my femoral vein to do a uterine artery embolization because of this AVM. So when he went in, he was like, I don't think it's an AVM. It's still retained products. So then I go back and have a second DNC with a his basically to do it a scope to look and do the DNC to make sure everything's out. So over the course of these months, I had medication management. I had two DNCs CT scan.

I have like a balloon basically where my femoral artery is. So way complicated procedure here. I never once got a mental health referral or any kind of support group and clearly mentally was not okay. So that was my miscarriage experience. And over the years, because we know how common is, I've seen lots of women go through it and it...

Dr. Shannon (08:47.693)
Mm -hmm.

Hannah Meurer (09:08.944)
We overcomplicate, just like we do with birth, we've overcomplicated and we don't practice evidence -based care in this specific arena. And I think women don't know the options that they have. I've talked with hundreds of ladies of, the doctor told me this, I could do this or this. And that's it. And they want you to make a decision right then and there. You're in shock. You're like, what just happened? Like I just announced my pregnancy.

Dr. Shannon (09:23.533)
Mm -hmm.

Dr. Shannon (09:29.133)
Mm -hmm.

Hannah Meurer (09:36.592)
And there's actually more evidence -based procedures that we do, just not here in this country. So, in all of my frustrations with my own moms, in my own experience too, I was like, we've got to find a better way. We need to find a place that's just for them. Even if you're diagnosed at your OB office, we can manage the rest. We can talk to you about options.

Dr. Shannon (09:44.749)
Hmm.

Hannah Meurer (10:01.84)
We have a partnership with Miscarriage Duelas. So as soon as you get diagnosed, they walk through the process with you. You're surrounded by people who are empathetic and see you through the whole process. So that's the heartbeat of what we do. We're not open yet. So the plan is we're a nonprofit, we're a business. I obsess over quality and also am so intentional that I want everything.

Dr. Shannon (10:05.645)
Mm -hmm.

Hannah Meurer (10:29.84)
to go smooth, especially considering the nature of who we're supporting. So the plan is to open, it is, it is, and I don't.

Dr. Shannon (10:33.261)
Right. Yeah, it's delicate. You don't want to add trauma to the experience, yeah, which is what you would have had. So, yeah.

Hannah Meurer (10:41.648)
Exactly. It is. And so for me to be able to create this space, have an amazing medical team where people feel supported. And I want the overarching, if I could scream it, miscarriage does not have to be traumatic. It is devastating. And it is, you're going to grieve. The healing is just an ongoing process, but you can still feel supported in it.

Dr. Shannon (10:52.493)
Mm -hmm.

Dr. Shannon (11:01.005)
Mm -hmm.

Hannah Meurer (11:11.216)
and you don't have to do it alone. And so just by putting even miscarriage in the name, it makes it more visible. People can relate to it and it changes the narrative in a way. Like we're talking about this, we've created a place for it because it happens. And if and when it does happen, you know there's a place for you.

Dr. Shannon (11:27.085)
Mm -hmm.

Dr. Shannon (11:32.781)
Yes, but that's exactly, I know why you have created it because of your own experience there. So unfortunately, I know that's so sad and so traumatic, but then seeing what can come out of that and noticing that need as well. Now,

Hannah Meurer (11:41.808)
Mm -hmm. Mm -hmm.

Hannah Meurer (11:51.472)
Yeah.

Hannah Meurer (11:55.184)
Yeah.

Dr. Shannon (11:56.205)
You've been a certified nurse midwife, you said since 2015. So what brought you into the world of midwifery? Which is, I guess that's kind of interesting as far as bringing you into that world of midwifery and then having that experience and then now where you get to be like, I don't know. I think I have a little bit of chills from that. So how did you get started in the midwifery field?

Hannah Meurer (12:01.487)
15.

Hannah Meurer (12:07.248)
Yeah.

Hannah Meurer (12:16.784)
Yeah.

Hannah Meurer (12:21.538)
So I decided in third grade, I wanted to be a nurse. That's what I wanted to do. I always loved science. I was like doing slime labs. I was dissecting, you know, worms in the yard. My dad was biology, pharmaceutical. I mean, he was, he got down and dirty with me with all this stuff. So I was like, nothing grosses me out. I want to be a nurse. Funny enough, I have all sisters and I was like the tomboy in the family.

I had all guy friends. So ironically, I work with women and see vaginas all day, because I was, you know, I'm like the tomboy, but I'm like, it just, it worked out perfectly for who I am and my personality. I am an empathetic person. I've always said the day that I can't cry with my moms, like that's the day I need to be done. And I obviously absolutely love it.

Dr. Shannon (12:56.013)
Hahaha

Dr. Shannon (13:11.285)
Mm -hmm.

Hannah Meurer (13:15.664)
So it just kind of morphed into women's health and in helping ladies. And as I look back, I remember in high school, one of my friends like taking her to the bathroom and doing pregnancy tests, you know, in high school. And so it just kind of has always been ingrained of like who I am. I liked helping people and the vulnerability of birth and the space that I'm welcome into, I just...

I've never taken that lightly. It's a gift, honestly, to see women a lot. I mean, you look through your social media, it's just not as real as it is when you're seeing someone at their most vulnerable and the cellulite and the varicose veins. And I'm like, I had those too, I get it. It's such a gift to me. So yeah, there wasn't necessarily like a distinct point, but it's been an evolution finding this niche.

Dr. Shannon (14:06.028)
Mm -hmm.

Hannah Meurer (14:14.736)
And I absolutely love what I do.

Dr. Shannon (14:18.253)
Yes, now have you always practiced in Georgia? Because I know you went to Vanderbilt University, but you've kind of ended up here in Georgia in that midwifery world, okay.

Hannah Meurer (14:25.104)
No. Mm -mm. Mm -mm.

Correct.

Right, so born and raised here. And then I went to the University of Georgia, Go Dogs. And then I went to Mercer University. And then I went to Vanderbilt to end. And I stayed in Vanderbilt, or I stayed in Nashville, excuse me, for about five years. And then was at Houston Methodist at a practice in Houston for a few years, and then came back here and worked at North Bolton.

Dr. Shannon (14:39.725)
Go dogs.

Hannah Meurer (15:00.592)
So I've only been hospital -based, but it's really, really been interesting to see the difference, I call the climate of the birth world in each city, because it's very, very, very different and surprising actually.

Dr. Shannon (15:04.589)
Mm -hmm.

Dr. Shannon (15:16.301)
That is really surprising, especially when you hear about birth centers and what's allowed in some states and what's not allowed and who's allowed to practice and who isn't. And we don't have to get into all that, but it is, I know, right? goodness. But that is kind of fascinating in a good and bad way because you have moms that are in other states where it's like.

Hannah Meurer (15:22.352)
Mm -hmm. Yeah. Mm -hmm. Right. How many hours do you have for that conversation?

Hannah Meurer (15:38.064)
Right.

Dr. Shannon (15:40.621)
or in rural areas where they don't have access to certain things. So, you know, there's that aspect too. Or when it's kind of like, no, the evidence says that we can do these type of births and the other states aren't allowing it. That's a little bit like, a little bit stinker.

Hannah Meurer (15:43.728)
Yeah, yeah.

Hannah Meurer (15:49.904)
man.

Yep, absolutely.

Dr. Shannon (15:54.381)
I'm there as well. Okay, so you became a midwife before having all of your children Correct. Okay. So how did being a midwife do you think shaped? Those birth journeys and then tell me a little bit about when in like how many children do you have in which one? Where was the miscarriage in? that lineup

Hannah Meurer (15:56.784)
Mm -hmm.

Hannah Meurer (16:01.296)
Correct.

Hannah Meurer (16:14.32)
Yeah. Sure, sure. So having the knowledge, well, back it up. Obviously I'm passionate about what I do. I decided I wanted to be a midwife. I became a midwife at 23. So super young. I was like, this is what I want to do. I accelerated through, you know, three schools and was like, I want to do it. I want to serve. This is what I want to do. Being a midwife, going into pregnancies and as a mom.

Dr. Shannon (16:29.325)
Yeah.

Hannah Meurer (16:43.568)
is a blessing and a curse as I'm sure you've probably heard before. It's like, you know too much in a sense. I just always, I think you have this expectation, I think everyone does, whether you're in birth work or not, you have this expectation of like what my births are gonna be, what it's gonna look like, what my life's gonna be. I'm like a very organized person, you know, obviously I obsess over quality, all the things. So my first pregnancy,

Dr. Shannon (16:46.701)
Mm -hmm. Mm -hmm.

Hannah Meurer (17:12.336)
got pregnant right away, no issues. And things just started to get worse and worse as the pregnancy progressed. So at first they thought, you know, it was a low lying placenta and a villaminous cord. And then by 20 weeks, they were like, it looks like a vasoprevia. And then 24 weeks, they confirmed vasoprevia. And so,

I'm a super healthy person. I remember the MFM doctor was like, you're literally the healthiest person ever. Like in my office, you just have this crazy phase of previa, normal blood pressure, all the things. And for those who don't know what a vasoprevia is, you probably are in a placenta previa where the placenta is covering the cervix. Vasoprevia, the placenta is not covering, it's low line, but all of the vessels in the cord.

Dr. Shannon (17:44.621)
Mm -hmm.

Hannah Meurer (18:03.248)
are not in that protective Wharton's jelly, so they're just over the cervix exposed. And then they did come together before they went into, you know, her belly button, but it's like a broom basically of vessels over the cervix. Also was moving, so moved to Houston. Had to be in the hospital starting at 32 weeks because if you start contracting, if your water breaks,

Dr. Shannon (18:14.573)
Mm -hmm.

Mmm. Mm -hmm.

Hannah Meurer (18:32.048)
then it can rupture that vessel. If your cervix starts dilating, it can rupture that vessel or those vessels that are over the cervix. And then you're on the clock to get baby out at that point. So the grieving process of the C -section started early in pregnancy. I distinctly have visions just laying on the couch crying. I was like, this is not the plan. Like my mom had all vaginal births. My husband's mom had all vaginal births.

Dr. Shannon (18:43.597)
Mm -hmm.

Dr. Shannon (18:48.877)
Mm -hmm. Mm -hmm.

Dr. Shannon (18:54.797)
Mm -hmm.

Dr. Shannon (19:01.197)
You're like, I'm a freaking certified nurse midwife and I do this for my two conventional births. Mm -hmm.

Hannah Meurer (19:05.712)
And it was the most helpless feeling because I was like, there's nothing I can do. I can't curb walk enough. I can't, you know, do all the things. I can't move it. You know, the low line placentas will move most of the time. But this was just really, it was just really grim and bleak. And so my anxiety really started to get bad. I had trouble bonding in the pregnancy.

Dr. Shannon (19:11.213)
Mm -mm. Mm -mm. Mm -hmm.

Dr. Shannon (19:18.637)
Right, this was different. Yeah.

Hannah Meurer (19:30.736)
So a lot of mental health in that pregnancy, it was very helpless and isolating and thank goodness we have C -sections, right? So they wanted her to be delivered between 34 and 36 weeks. I really pushed for 36 weeks. She did great. She was six pounds, seven ounces. So she was a good size. And I was prepared for the C -section. So I was prepared.

Dr. Shannon (19:39.949)
Mm -hmm. Mm -hmm.

Dr. Shannon (19:47.885)
Yeah.

Dr. Shannon (19:57.485)
Mm -hmm. Yeah.

Hannah Meurer (20:00.08)
I stayed in the hospital for, you know, from 32 to 36 weeks. So I got to see the like, the antepartum side of just sitting in a hospital for four weeks. And thank goodness I didn't have other children. I can't imagine the moms who have to, you know, stay in the hospital for months on end. So that was Lenny's birth. And so it was, it was okay. Postpartum was awful.

the anxiety just snowballed into postpartum OCD. And because I was a midwife, people were like, she would, you know, I remember my husband saying she would tell me, like you would tell me. I'm like, no, I wasn't like, it was my first baby too. Like I would eat lunch in her room, making sure that she was breathing. I obsessed over the temperature had to be between 68 and 72 degrees. I'd wake up multiple times throughout the night to just like make sure the temperature was good. And I was like,

Dr. Shannon (20:41.421)
Yeah.

Hannah Meurer (20:58.672)
SIDS prevention obsessed with her and I never got the help I needed until later. So fast forward to like perfect timing, you know, she was two, got pregnant right away with Haven. So Haven is the baby I miscarried. And I was, you know, working at Houston Methodist and I would scan myself and a lot of lost moms say this where they're like, something just feels off, something feels wrong, like an

Dr. Shannon (21:02.285)
Mm -hmm.

Hannah Meurer (21:28.016)
intuition. And I remember crying, like even when there was still heartbeat, I remember crying talking to my mom and I was like, you know, I mean, it still has a heartbeat now. And just kind of feel like casually, you know, like, something might be up with this. And so yeah, I was 10 and a half weeks and Haven was measuring about like nine and a half weeks. And so that was my second pregnancy. And then,

Dr. Shannon (21:43.085)
Mm -hmm.

Dr. Shannon (21:49.485)
Okay.

Dr. Shannon (21:53.293)
Yeah.

Hannah Meurer (21:56.88)
the whole process happened and it's interesting because I know a lot, but we still have a culture of secrecy and hiding loss. And in a way, I felt embarrassed and I needed to get pregnant again to cover it up. Almost like I'd done something wrong, even though I totally, right.

Dr. Shannon (22:11.213)
Mm -hmm.

Dr. Shannon (22:15.405)
Mm -hmm.

Dr. Shannon (22:20.589)
Yeah. Like, yeah, a little bit of like shame or guilt. Mm -hmm. Mm -hmm.

Hannah Meurer (22:24.72)
Right, even though I know without a doubt there's nothing I did to cause it, but there's this subconscious, like I just need to get pregnant away to like cover up what happened. Like it's sad, but it resonates even I'm not immune to those feelings that come with it and that we've perpetuated as a society. So got pregnant fairly quickly after and...

Dr. Shannon (22:33.357)
for him.

Mm -hmm.

Dr. Shannon (22:39.885)
Mm -hmm.

Hannah Meurer (22:52.848)
I knew it was going to be my healing birth. LOL. It wasn't. Newsflash, it wasn't. And I just was like, this is how it's going to happen for me. Like, I'm going to have a vaginal birth. No problem. Like, I did all of the things. Solved chiropractor throughout. Drank my red raspberry leaf tea. I drank ochre water. I did all of the things.

Dr. Shannon (22:55.917)
Hmm. gosh.

Yeah.

Dr. Shannon (23:12.717)
huh.

Dr. Shannon (23:22.381)
huh.

Hannah Meurer (23:22.384)
possible. I was climbing Kennesaw Mountain at 41 weeks. So I went to 42 weeks and didn't go into labor. And probably a lot of that is, you know, my mental health too. I'm a firm believer, like, you know, our parasympathetic and sympathetic nervous system. And I convinced my doctor, I was like, let's just do it. I was like, I don't want to mess, especially following a loss. I was like, I really

Dr. Shannon (23:36.525)
Mm -hmm. Mm -hmm.

Hannah Meurer (23:50.96)
I'm not comfortable going past. I obviously not gonna do anything risky. We did testy. She was pushing 41 and the whole game that you guys probably talk about all the time on this podcast. And so I was like, you can do it. Let's do a gentle induction with a balloon, low dose pitocin. She was like, I don't think I can get a balloon in. I was like, you can. She did. I was like, told you. We're the worst patients, right?

Dr. Shannon (24:17.901)
You heard them? Yes.

Hannah Meurer (24:21.328)
I was contracting my cervix just wasn't opening. So we went up to 20 units of pitocin. Nothing happened. We did a pit wash, went up to 20 units of pitocin again. Nothing happened. She was still stable. And so I was like, I'm reasonable. Let's just do a C -section. And this was after well over days. So had a C -section. I should have sent you some of the pictures of me crying because it just.

Dr. Shannon (24:24.493)
Hmm.

Hannah Meurer (24:51.888)
I was not prepared. I did not prepare in the least bit because I just knew I manifested this vaginal healing birth and it just was not even on my radar to have a C -section. And I called my friend midwife back and I'm like, am I doing the right thing? What do I do? You know, should I just call it? Cause I wanted to do skin to skin. I wanted to breastfeed in the, like I wanted to do all the things. And I was like, I don't want it to be a crash C -section situation. And then of course she aspirated meconium and was taken away.

Dr. Shannon (24:59.373)
huh.

Dr. Shannon (25:08.013)
Mm -hmm.

Hannah Meurer (25:22.224)
And so I didn't get that, even though that was the whole reason for choosing it. So postpartum once again, it sucked. And luckily, like I had been seeing a therapist, you know, through her whole pregnancy and then after, and I started Zoloft after, because I was like, I need some help here coping with this. So the first C -section, I very much was like more prepared and grieved for in the second.

Dr. Shannon (25:29.005)
Yeah.

Dr. Shannon (25:41.869)
Mm -hmm.

Dr. Shannon (25:45.805)
Yeah.

Hannah Meurer (25:51.568)
not at all. And so it was very, very different. So two C -sections and then the miscarriage in between. And the childbearing years for me were the most traumatic years of my life. Bye Clark.

Dr. Shannon (25:52.749)
right.

Dr. Shannon (26:05.357)
Yeah, I mean most definitely. that's so tough. Like you hear it and it's, I mean sometimes us birth workers do have some of like those crazy stories, but you had already, you were already a midwife and then had to walk that in the aspect of like, this is not what I thought it was gonna be at all. Birth has a way of doing that.

Hannah Meurer (26:08.496)
Mm -hmm.

Yeah.

Hannah Meurer (26:26.928)
Mm -mm.

Hannah Meurer (26:31.248)
It does, it's so humbling, because you can do so much and yet you're still having to surrender to this process. It's so beautiful most of the time, but it also is so humbling a lot of the time too. And it can simultaneously happen too.

Dr. Shannon (26:34.541)
Mm -hmm. Mm -hmm.

Dr. Shannon (26:41.517)
Mm -hmm.

Dr. Shannon (26:52.301)
Now, how was, and you continued after your last pregnancy, did you continue to be a midwife? Like was that still a difficult space to work and be in?

Hannah Meurer (27:00.304)
Mm -hmm. Mm -hmm.

Hannah Meurer (27:06.032)
But we compartmentalize in this world. Yeah, it just, I mean, I remember being pregnant, delivering babies, stillbirth babies at 37 weeks, you know? And that kind of trauma and loss, it kind of became my specialty because a lot of, especially like providers, like I only want the happy stuff, right? Like I want to deal with this. But there's...

Dr. Shannon (27:06.637)
No? Yeah. Mm -hmm. -huh. Mm -hmm.

Dr. Shannon (27:18.797)
Mm -hmm. Mm -hmm.

Dr. Shannon (27:29.997)
Mm -hmm.

But this is part of life. This is part of it. To walk them through this.

Hannah Meurer (27:34.64)
But there's such a need for someone to hold your hand through. And I give them the pictures. I give them all of it. There's so many people who've lost babies, and they don't even have an ultrasound picture to take away from it. And so to be able to walk through that and check in and give that intentional care, I get really selfish with those moms. Because I want to give you a level of care that I know a lot of people won't.

Dr. Shannon (27:48.589)
Hmm.

Hannah Meurer (28:04.048)
and they won't take the time to give you.

Dr. Shannon (28:04.141)
Yeah, and you know the healing capability that can come with that support as well too, you know? And so I think that's a beautiful thing that you're able to offer as well as part of your journey. Now you mentioned ultrasound. So tell me what...

Hannah Meurer (28:08.4)
Mm -hmm.

Hannah Meurer (28:12.848)
Yeah, yeah, yeah.

Hannah Meurer (28:25.52)
Yes.

Dr. Shannon (28:26.701)
What are the services that Haven offers? And I'm gonna put all the links that you have, like the social, the website and everything, and I wanted to mention you have a wonderful resources page on the website as well too. So walk me through what are the services that Haven offers.

Hannah Meurer (28:29.808)
Mm -hmm.

Hannah Meurer (28:38.928)
Mm -hmm. Yeah, yeah, yeah. So what, yeah, great question. So what makes us different, there's loads of resources, right? Because of how common miscarriage is a lot of people too in the healing, like in keeping their baby alive, you know, we'll do something like this, like create support groups or Held and Hope has like boxes. There's so many great resources.

What makes us different is we're actually the clinical side of it, so the management side. And that's what there isn't any of. So from the top, especially with abortion laws being so strict here, everyone has to have an ultrasound just to confirm that baby's not viable anymore. So ultrasound, we talk about counseling options. So,

If you're already having symptoms, what that looks like versus if it's what we call it a missed abortion or missed miscarriage where we just find out the baby doesn't have a heartbeat, but you're not having any of the symptoms yet. We can either wait. We can do medication management. We can do in office uterine aspiration, which could be a whole nother podcast in and of itself. We don't use that here, but it's 98 % effective and it's more effective and safer than DNC. It can be done.

in five to 15 minutes outpatient, but in this neck of the world, which is a whole nother conversation also about cost in our healthcare system. Let's not get into that. It's just not offered. So it's really not, it's not the most, DNC is not the most effective surgical option. It can be done via uterine aspiration in a cost -effective way outpatient.

Dr. Shannon (30:15.437)
I was gonna say, that's all. There's so much to this. I know. Yeah.

Hannah Meurer (30:33.776)
So we're planning to offer that option in office. And then follow up blood work. So like your HCG, your CBC, and then also post miscarriage if you want to come back for like a panel of screening. So some of the more common causes of miscarriage, like if you have a clotting disorder, if there's any underlying thyroid issue, something that could potentially be treatable.

Dr. Shannon (31:01.453)
treatable.

Hannah Meurer (31:03.216)
and that avoids having to wait until you've had three miscarriages to go to like a fertility specialist or get in with your OB. So after your miscarriage, that testing's available and then also genetic testing for the baby. So if you've had a procedure in office, we can save that tissue. Otherwise, if you had it at home, then you can bring that in and we can send it off for testing to see if there were any chromosomal abnormalities. And then...

I've already mentioned the miscarriage doulas too. So we've already partnered with a fabulous organization. And to me, like if I was just offering this, then that would be worth it. So they give you, no matter what option you choose, these doulas, which I'm obviously a huge fan of doulas just to begin with, they give you a list of all the things that you need at the store, like all the things to be prepared. They've all had losses themselves as well. And then,

Dr. Shannon (31:42.093)
Mm -hmm.

Hannah Meurer (31:58.96)
say you wanna do medication management, they're on call for you so they can like walk you through that process. Most people don't want face -to -face when you're going through loss. So just having that virtual like, hey, what's normal, what's not, what can I expect? And having that resource from someone who's been there before is just amazing. And the followup.

Dr. Shannon (32:09.933)
Mm -hmm. Mm -hmm.

Dr. Shannon (32:19.821)
That's priceless.

Hannah Meurer (32:23.536)
And then last but not least, because this is another real big push, is everyone gets a mental health consult. So it might be like, things are good, you seem like a good candidate for a support group, so we're gonna plug you into this virtual support group for lost moms, or it might be, hey, we need to continue therapy sessions, and then go from there, but no one flies under the radar for mental health.

Dr. Shannon (32:30.957)
Mm -hmm.

Dr. Shannon (32:49.645)
Mm -hmm. That's, I mean, again, too, that's priceless as well. And that's, I think that's important, because you even mentioned in your story, it's like, she's a midwife. She knows, she knows the things. It's almost like, she's strong, she can handle, you know, like that type of thing where it's like, mm, like, we could all use, you know, that support or the knowledge, that option of it, or.

Hannah Meurer (32:54.384)
Mm -hmm. Mm -hmm.

Hannah Meurer (33:05.456)
Mm -hmm, yeah.

Right.

Dr. Shannon (33:14.829)
Someone to just, without you having to decide it too, to kind of be like, here's the screening, here's the results, this is a good thing to support you, you do with it what you want. Mm -hmm, mm -hmm.

Hannah Meurer (33:18.896)
Right.

Hannah Meurer (33:24.88)
Right. Yeah, yeah. And you at least know the resources are out there because especially the grieving process, it alters our brain so much. We lose our reasoning. And when you're in a hole, you're not like, I'm just gonna go call, cold call therapists, right? So by planting the seed already there,

Dr. Shannon (33:45.261)
Mm -hmm.

Hannah Meurer (33:51.6)
they're more likely, if I already have someone in my back pocket, to actually follow up if something's going on. They're just not going to initiate on their own. Or I didn't. I didn't. Yeah.

Dr. Shannon (33:58.829)
They're not going to initiate exactly. Yeah. Yeah. I think that's, I think that's a very common case though. You know, so I was definitely not initiating it now.

Hannah Meurer (34:06.928)
Mm -hmm. Mm -hmm.

Dr. Shannon (34:09.901)
There are lots of different types of miscarriages. I want to go through all the different types, but there's a ton. Whenever I looked it up. So with your clinic, are you only dealing with the specifics of early and early as the definition of 13 weeks and earlier? Is that okay?

Hannah Meurer (34:14.512)
Yeah, there's a time.

Hannah Meurer (34:27.088)
Yes. For now.

Yes, so up to 13 weeks, so up to 12 weeks and six days by definition because that's so much easier to manage outpatient and there's over a million women who go to the ER for this every year and which is just mind blowing because less than 2 % of the time there's any complications. So we're starting there and we might open up after but that's going to be the start of management is early pregnancy loss.

Dr. Shannon (34:37.933)
Mm -hmm.

Dr. Shannon (34:41.645)
Mm -hmm.

Dr. Shannon (34:45.645)
Mm -hmm.

Dr. Shannon (34:50.829)
Mm -hmm.

Dr. Shannon (34:54.893)
Okay.

Dr. Shannon (34:58.605)
Mm -hmm.

Hannah Meurer (35:00.496)
Now as far as all the diagnosis of threatened AB, missed AB, spontaneous abortion, you know, all those diagnosis, all are welcome. And if people are beyond the 13 weeks, we're gonna plug them in with resources. We're not gonna turn anyone away. But as far as management goes, whether you're having symptoms, exactly, it's just early right now. And then whether you're having symptoms,

Dr. Shannon (35:07.981)
Mm -hmm.

Dr. Shannon (35:15.405)
Exactly. The clinical management.

Hannah Meurer (35:26.672)
and haven't seen an OB or haven't had any kind of diagnosis, you can come into the clinic, you don't need a referral from a provider. If you were confirmed in an office, you can come for a second opinion because some, I mean, some people are just like, what just happened? It was so quick. They were like, there's no heartbeat, do this, do that. They're like, I have no clue what just happened. And I've had some moms who are like, just want to like sit with it for a minute and.

Dr. Shannon (35:33.677)
Okay.

Dr. Shannon (35:44.717)
Mm -hmm.

Dr. Shannon (35:49.933)
Mm -hmm.

Dr. Shannon (35:53.965)
Yeah, like get me out of this space real quick and let me process it.

Hannah Meurer (35:56.656)
Right. Right. And so there's definitely room for that too, where it's been diagnosed, come back, we'll patiently talk through options and sit down, go over what that's going to look like and then follow up with what you're comfortable, do a secondary ultrasound too. So it can look like a few different ways with it.

Dr. Shannon (36:19.565)
Yeah, no. That's really good. That kind of covered my next of like who can reach out for services. And I mean, I'm assuming too, if you've had...

Hannah Meurer (36:27.664)
Mm -hmm. Mm -hmm. Yeah.

Dr. Shannon (36:38.477)
If there's moms who have had a miscarriage and are pregnant again, they can even come as far as like, well, what are some like the mental health resources there as well too? So, you know, everything's fine with maybe this second pregnancy, but that head space and you know that is, it's very different. It's very different. So, mm -hmm.

Hannah Meurer (36:49.552)
Yeah.

Hannah Meurer (36:53.68)
Sure.

my gosh. my gosh, yeah.

And at Pregnancy After Loss is a whole other realm of mental health and anxiety. And so we absolutely can provide resources, but having a birth doula as well, who has either been through loss or is experienced with that is just so invaluable to have someone walking through that with you and a support group. There's tons of Pregnancy After Loss support groups.

Dr. Shannon (37:06.317)
Mm -hmm.

Hannah Meurer (37:28.912)
because there's so many feelings, so many feelings.

Dr. Shannon (37:33.837)
So I know you've talked about like, okay, we're set on the early pregnancy loss with the potential of, you know, in the future branching out. Do you have any other potential of branching out or bigger goals or things that you see with the clinic? Or I know you're still just kind of like, I want to get this off the ground, but it's also good to have, you know, like those big things.

Hannah Meurer (37:41.392)
Mm -hmm.

Hannah Meurer (37:56.72)
Yes, yes, yes, yes, yes, yes, yes,

Dr. Shannon (38:16.589)
Mm -hmm.

Dr. Shannon (38:25.005)
Mm -hmm.

Hannah Meurer (38:25.456)
first get her and then we can expand from there. Because there's so many things that go into it, which is why as I dove deeper into this, I'm like, how is this not a specialty? You have the lab aspect and the management that can be complicated sometimes in the mental health. There's so many aspects of just early pregnancy loss and how common it is. So that's definitely the focus right now. Would I love to see one of these everywhere? Yes, I would.

I would. And I've already had many people reach out who are like, my gosh, we need this in our city, in our city, because it's just so, it's so needed. And the visibility of just having a place to go for a miscarriage is, I think, incredible. So, of course, I want to master it here. And then I'm like, if people want to steal my idea, go for it. Like.

Open up your own clinic. Like there's no ego about it. Like I want to serve women and give them a place to go, give them the best kind of empathetic care, make it cost effective too, as much as possible. I had a patient this year pay $13 ,000 for her DNC in the hospital after insurance.

Dr. Shannon (39:39.757)
I'm like, that's... that doesn't make any sense. Like, at all.

Hannah Meurer (39:39.952)
after insurance.

It's more expensive than most people have to pay for a birth. So at the end of the day, you're grieving over a wanted baby, and then you have a financial burden on top of that. And then you're like, is another pregnancy even on the table because of this financial burden? And so there is an inequality with what we're offering, which could be a whole, once again, I've opened up five more podcasts for you.

Dr. Shannon (39:52.557)
Mm -hmm.

Dr. Shannon (40:03.821)
Mm -hmm.

I love it. I know.

Hannah Meurer (40:10.384)
But uterine aspiration is what's done in an abortion procedure, right? So that's where it kind of has a little bit of a stigma, but you can have it covered through insurance. Otherwise $500 max out of pocket is what I don't think I don't know if I can say the names, but what the national abortion clinic charges $500. They do not take miscarriage clients. I have called them to see if they will take miscarriage clients.

Dr. Shannon (40:15.565)
Mm -hmm.

Dr. Shannon (40:19.469)
Mm -hmm.

Dr. Shannon (40:30.925)
Mm -hmm.

Dr. Shannon (40:34.797)
Mm -hmm.

Dr. Shannon (40:40.557)
Mm -hmm.

Hannah Meurer (40:40.656)
They say if it's any kind of miscarriage, it's perceived to them as a liability and they recommend they go to the ER. So I'm like, granted 13 ,000 is steep, but still, 13 ,000 versus 500, that's a huge difference. And so to be down here is my goal.

Dr. Shannon (40:51.661)
Mm -hmm.

Versus 500. Yeah. Yeah.

Dr. Shannon (41:01.197)
Yeah, yeah, no. Yeah, that makes sense. That makes sense. Okay, so what are some ways that people can then help Haven Miscarriage Clinic? Because you're just getting started and so, yeah, what are some ways that people can help?

Hannah Meurer (41:02.96)
Maximum.

Hannah Meurer (41:06.864)
Mm -hmm.

Hannah Meurer (41:15.344)
Yeah, yeah, for sure.

Hannah Meurer (41:21.744)
Yeah, so we are a nonprofit and I did that on purpose because there are so many people who miscarriage has touched, right? And people want to give back in a way. So to be able to accept donations and be tax exempt, it was really like the heart with it to be able to do data collection and get grants and keep it all within the mission was

was really the goal of it. So obviously donations as we get started because right now we're getting equipment together, we're obviously getting staff together, we're planning to have a big fundraiser launch event in September in Atlanta. So if people want to volunteer, if there's people who are like, my gosh, I had a miscarriage, I'd love to work here, we're still looking for some staff. So volunteer staff, donations.

I've had such a warm response to this. It's been really humbling, but there's so many women, I have heard their stories loud and clear, and in developing all of this, they've been so encouraging, and that's just helpful too. So many people are like, how can I help, what can I do? And there's not always an answer other than like, I'll keep you posted.

Dr. Shannon (42:46.797)
Mm -hmm.

Hannah Meurer (42:46.8)
But I can use just about anyone, no matter your skills.

Dr. Shannon (42:49.777)
Yeah. Spread the word. Yeah.

Hannah Meurer (42:52.688)
So whatever people are willing to give, we will totally accept. But just even talking about it and continuing like the dialogue of early pregnancy loss and miscarriage care is just so helpful.

Dr. Shannon (43:04.429)
Mm -hmm. Yeah, I mean in talking about it, you know, that's the whole reason to hear I mean we love our podcast but there's we talk about so many things on the show because I know when I went through my pregnancies

Hannah Meurer (43:07.472)
Yeah. Yeah.

Dr. Shannon (43:16.205)
you know, 14, 11 years ago, there were certain words that I never even heard, I never even heard doula. And so like, yeah, that would have been great. So it's almost like exposing people to certain words, yes, but then there's also the aspect of kind of reducing the stigma with miscarriage and that, you know, and just, it's okay to talk about it. It is very common. It is very grieving, you know, like it's very, very sad. So it's just because it is those things doesn't mean we, you know, we don't have to talk about it. So.

Hannah Meurer (43:18.256)
Mm -hmm.

Hannah Meurer (43:23.472)
Alright.

Hannah Meurer (43:26.928)
Right.

Hannah Meurer (43:32.656)
Mm -hmm. Mm -hmm. Yeah, yeah.

Hannah Meurer (43:44.834)
Right, well and we educate, we do a good job of once someone is pregnant and it's a viable pregnancy, we educate on all the things, right? I remember in Houston, I had a 36 week, we had a whole checklist appointment where I would talk about all the scary things that can happen and I prepare them for all the scary things like shoulder dystocia, this is what it would look like, I'm gonna talk to you but this is what it's gonna look like or like if you're bleeding too much, here's what we give for hemorrhaging.

Dr. Shannon (43:52.749)
Mm -hmm.

Hannah Meurer (44:11.952)
and I would prepare them. And doulas do an amazing job at preparing them for possibly the unexpected that could potentially happen. Before you get pregnant, rarely does anyone say, hey, if you have a miscarriage, you have a loss. That's just not part of our counseling. Like during a well woman exam, they're not like, hey, there's a 25 % chance you could have a miscarriage. Here's what you would need to do. Here's who to call.

Dr. Shannon (44:18.861)
Mm -hmm.

Dr. Shannon (44:30.861)
Mm -hmm.

Hannah Meurer (44:40.272)
And so we end up picking up a lot of pieces after it happens. And people go to Google, they go to their mom who may or may not have had losses. And so it's interesting because it happens a little bit earlier on and the preparation is hard to do, but the visibility we can do and say, like there is a place and the more we talk about it, to your point, the more we talk about it, someone who gets pregnant and might have a loss is like, they talked about it. I can go find resources here.

Dr. Shannon (44:44.397)
Mm -hmm.

Dr. Shannon (44:54.413)
Mm -hmm.

Dr. Shannon (45:02.061)
Mm -hmm.

Dr. Shannon (45:10.253)
Mm -hmm exactly. So where can people Find you so is their website social media all of that. So tell me all the locations

Hannah Meurer (45:16.528)
Yeah.

Yes, so the big mouthful Haven Miscarriage Clinic, you gotta spell miscarriage right, it's a trick, is the website, two Rs. HavenMiscarriageClinic .com is the website and then it's the same for Instagram, everything is the full mouthful. And then on the website, there's our email address, there's our phone number, wecareathavenmclinic .com if there's any questions.

Dr. Shannon (45:26.637)
It is a trick.

Hannah Meurer (45:47.312)
And then it'll be kind of more active and up and running for actual client referrals once we're open. But we'll slowly be introducing our staff as the months go on too through Instagram and be doing some lives. So a lot of the announcements will come out through Instagram.

Dr. Shannon (46:05.421)
Very good. Let's see, anything else that you want to mention or talk about that we haven't chatted about or that we didn't go over, especially as it pertains to the clinic and the offerings and that type of thing? Yeah.

Hannah Meurer (46:19.792)
Hmm.

Hannah Meurer (46:24.368)
Yeah, I think we've covered most of it. I usually hate talking about myself, so I'm like, tell me about you. I'm like, tell me about you. But I know this is the platform to share about me. So yeah, no, I think we've talked about all of it. I am so excited to be offering this. It is the most devastating thing, but there is hope, and that is what I want to communicate to people. There is hope.

Dr. Shannon (46:34.253)
Yes! Yeah! No.

Hannah Meurer (46:52.976)
We want to be that haven for people to come to and be able to offer all of these things. And I'm really, really excited to be able to offer it.

Dr. Shannon (47:04.941)
Yes. I want to say special thanks for sharing your story because I know, I mean, it's tough to go through and share it again. And it is a big part of who you are and what you're doing. So I'm excited for this clinic. It's, I guess I'm sad that it's needed, but I'm also very excited for.

Hannah Meurer (47:14.576)
Yeah.

Hannah Meurer (47:19.536)
Absolutely.

Dr. Shannon (47:30.733)
the potential it has for like healing and the potential it has for helping a lot of families in general as well too. So thank you so so much for being on the show today, Hannah.

Hannah Meurer (47:32.528)
Mm -hmm. Absolutely, yeah.

Hannah Meurer (47:41.232)
Mm -hmm.

Hannah Meurer (47:45.968)
You are so, so welcome. Thanks for having me. It was an honor.